No. J1813 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code.

What NDCs are billed under J1813?

CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J1813, for Lyumjev. The table on this page shows each one with its billing units per package.

What is the Medicare payment limit for J1813?

$3.903 per 50 units, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.

J1813 J-Code: Lyumjev

In short

J1813 is the HCPCS Level II code for insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units. CMS assigns NDCs for Lyumjev to it. The Medicare Part B payment limit is $3.903 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ1813

Billing unitSee descriptor

Descriptor: Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units
Short descriptor: Lyumjev for insulin pump use
Code set: HCPCS Level II, maintained by CMS
Effective: Jan 1, 2024

Medicare Part B payment limit

CMS ASP file

Payment limit per unit$3.903

Per50 units

Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

HCPCS units

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the units to build the claim line.

NDCs billed under J1813

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to J1813 for Lyumjev. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J1813 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Lyumjev	00002-7728-01	Eli Lilly and Company	10	20
Lyumjev	50090-7433-00	A-S Medication Solutions	10	20

J1813: common questions

Is J1813 a CPT code?: No. J1813 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J1813?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J1813, for Lyumjev. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J1813?: $3.903 per 50 units, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.

J1813 — Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units